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ENT: Oral, Head, and Ear Cancer
Cancer ENT
25
Anatomy
Graduate
10/08/2011

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Cards

Term
#1 oral cancer:
Definition
squamous cell carcinoma (SCC) (95% of oral cancers are this)
Term
incidence and survival of oral/pharyngeal cancer:
Definition
30,000 new cases diagnosed yearly
8,000 deaths each year
5 year survival rate: 50%

5-year survival for localized disease is 76%
5-year survival for metastatic disease is 19%
Term
Leukoplakia is ___ due to __ __. It is white and __ be rubbed off.
Definition
- hyperkeratosis due to chronic irritation
- cannot
Term
Erythroplakia presents as a __ __ __ or a mixed ___ __ and __ lesion.
Definition
- homogenous red macule
- mixed macula of red and white lesion
Term
Warning signs of oral/pharngeal cancer:
Definition
- Leukoplakia
- Erythroplakia
- soreness/lump in throat
- lump/thickening of soft tissue
- difficulty chewing/swallowing
- ear pain
- difficulty moving jaw/tongue
- hoarseness
- numbness of tongue/mouth
- swelling of jaw
Term
Risk factors for oral/pharyngeal cancer:
Definition
- Tobacco use
- Alcohol use
- Sunlight (lip cancer)
- Age (AA 55-64, Whites 65-74)
- Gender: twice as common in men
- Race: AA
Term
symptoms of oral cancer?
Definition
Swellings/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, or other areas inside the mouth.
The development of velvety white, red, or speckled (white and red) patches in the mouth.
Unexplained bleeding in the mouth.
Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck.
Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks.
A soreness or feeling that something is caught in the back of the throat.
Difficulty chewing or swallowing, speaking, or moving the jaw or tongue.
Hoarseness, chronic sore throat, or change in voice.
Ear pain.
A change in the way your teeth or dentures fit together.
Dramatic weight loss.
Term
sore in mouth that hasn't healed in 4 weeks is cancer until proven otherwise
Definition
Term
Oral SCC of the mouth physical exam:
Definition
- may look like leukoplakia
- FIRM
- PEARLY
- IRREGULAR
- ROUGHENED, VERRUCOID LESION
- Ulceration
- Heaped up edge
Term
other types of oral cavity tumors besides SCC:
Definition
- salivary gland tumors
- melanoma
- lymphoma
- sarcoma
Term
Hairy Leukoplakia occurs in what type of patients?
Definition
- HIV
- Epstein Barr virus
- Diabetics
- Immunocompromised
Term
Candidiasis is more fluffy looking than leukoplakia, it looks like __ of __. It __ be rubbed off. Treat with __ or __.
Definition
- curds of milk
- can be rubbed off
- Diflucan or Nizoral (antifungals)
Term
Most common type of external ear cancer?
Definition
Basal Cell Carcinoma
Term
Basal cell carcinoma description:
Definition
- small dome shaped bump
- covered by small superficial blood vessels called telangiectasias
- often shiny/translucent, may be called pearly
Term
62 yo WM, recurrent L ear drainage X 40 yr
Presents to ENT w/ L ear drainage, pruritis, & hearing loss
RX topical ABX gtts (successful in past)
S & S did not resolve oral ciprofloxacin X 4 wks
Declined aggressive W/U
Wanted 2nd opinion by VA
This Exam
firm, granular mass posterior 1/2 of EAC w/ occlusion of TM
Definition
biopsy, likely cancer

this one is squamous cell carcinoma
Term
cancer of ear may present with hearing loss, pruritis, and discharge
Definition
Term
Most common external ear canal cancer?
Definition
Squamous cell carcinoma
Term
Presentation of SCC in the external ear canal?
Definition
- BLOOD OTORRHEA- hallmark of malignancy, but rare and late finding

5 year mortality rate= 50% (lymphatic spread to cranial base)

BIOPSY ANY UNRESOLVING EAR ISSUE

TMT; EXCISION AND XRT (RADIATION)
Term
External ear canal cancer case:
Definition
BX
Well-differentiated SCC
CT scan
Tumor in posterior bony canal w/ soft tissue changes in mastoid & middle ear cleft
Audiometry
Severe, mainly conductive, L-sided hearing loss with flat tympanogram
TX
Excision w/ clear margins
Term
Most common INTRACRANIAL tumor:
Definition
Vestibular Schwannoma (type of acoustic neuroma)
Term
Vestibular Schwannomas usually occur ___. 5% are associated with hereditary syndromes such as ___ __ __ and __ __ __.
Definition
- unilateral
- Neurofibromatosis type 1
- Neurofibromatosis type 2
Term
Neurofibromatosis type 1 is aka __ __ ___. Pts with this condition are prone to ___ __ ___.
Definition
- Von Recklinghausen disease
- unilateral Vestibular Schwannomas
Term
Patients with Neurofibromatosis type 2 are prone to __ __ __.
Definition
- bilateral Vestibular Schwannomas
Term
Signs/Symptoms of Vestibular Schwannomas/acoustic neuromas?
Definition
- UNILATERAL SUDDEN HEARING LOSS
- speech discrimination affected
- CONTINUOUS DYSEQUILIBRIUM
- hydrocephalus
- HEADACHES
- possibly tinnitus
- facial numbness if CN VII damage
- decreased corneal reflex
Term
Neurofibromatosis is an autosomal __genetic disorder. Type 1 is characterized by ___, __ of the iris, __ __, and tumors of the __ __.
Definition
- neurofibromas
- hemartomas
- pigmented birthmarks
- tumors of the optic nerve
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